The technology we have to see what is going on inside our bodies is tremendous. However, it is not always helpful. Just like many of us develop wrinkles and gray hair, orthopedic changes in our body are normal. Since we know that many people have these changes (eg disc bulges or cartilage defects or neuromas) WITHOUT symptoms, we should realize that if a person has complaints we cannot automatically blame these changes. A thorough clinical exam with repeated movement testing is necessary for diagnosis. We find that the bulk of patients just have a joint that's not sitting quite right which can be resolved with movement.

If the patient's complaint is not resolving within several visits using the McKenzie method, then an image may be warranted to see if there is a structural finding that is consistent with the patient's complaint. This is rare, however - the percentage of times I request a patient get an image is under 5%. -- Laura